Child care licensees are expected to employ multiple strategies and a layering of controls to support healthier and safer environments for children and staff as detailed below. There is not one specific measure that will prevent COVID‑19 transmission from occurring in child care settings, but rather there are multiple structural and individual elements that contribute to making child care healthier spaces and reduce the risk of infection to in-person attendees.

Each of the control measures listed below provides some benefit in reducing spread. However, it is the combination and consistent application of these layered controls as a bundle that is most effective for reducing disease spread in child care.

Working with local public health

While the ministry is providing guidance on how to operate child care during the COVID‑19 pandemic, CMSM/DSSAB, licensees, and home child care providers must follow the advice of the local public health unit when establishing health and safety protocols, including how to implement any provincial or local public health unit direction on health and safety guidance.

The ministry recognizes that this may result in regional differences in these protocols, but given the different impact of COVID‑19 in different communities, it is important to follow the advice of local public health officials to keep children and families safe in their respective communities.

Contact information for local public health units.

Health and safety protocols

Every licensee must ensure that there are written policies and procedures outlining their health and safety protocols. Licensees must review policies and procedures with employees, home child care providers, home child care visitors, and students on educational placement.

These policies and procedures must be consistent with any direction from local public health units and include information on how the child care setting will operate to prevent and minimize the impact of COVID‑19 in child care settings, including, at a minimum, the following:

  • how cleaning and disinfecting the space, toys and equipment will be conducted
  • how physical distancing will be encouraged, particularly between groups
  • requirements on the use of medical masks or N95 masks (including non-fit-tested) and eye protection, and any other personal protective equipment (PPE), including information on exemptions or exceptions
  • how shifts will be scheduled, where applicable
  • how attendance records will be organized and maintained in order to facilitate contact tracing
  • rescheduling of group events and/or in-person meetings
  • parent drop off and pick up procedures

Under the Occupational Health and Safety Act (OHSA), employers must take every precaution reasonable in the circumstances to protect the health and safety of workers. This includes precautions to protect workers from exposure to infectious diseases.

Please see the guide on developing a COVID‑19 workplace safety plan to support you in fulfilling this obligation.

Immunization disclosure policy

The Chief Medical Officer of Health has issued instructions for licensed child care in accordance with the authority granted by the Reopening Ontario (A Flexible Response to COVID‑19) Act, 2020. These instructions require that all licensees establish, implement and report on a COVID‑19 Immunization disclosure policy.

All licensees under the Child Care and Early Years Act, 2014 are subject to these requirements until such time as they are revoked/rescinded.

Cleaning child care centres/homes

Cleaning protocols

Existing practices should be reviewed to determine where enhancements might be required, including frequency and timing of cleaning and disinfection, areas to clean and disinfect, choice of cleaning products, and child safety, staffing, signage and PPE use when cleaning.

Please refer to Public Health Ontario’s Environmental Cleaning fact sheet for best practices for cleaning and disinfecting, including:

  • which products to use, including disinfectants with Health Canada Drug Identification Numbers (DINs)
  • how to clean and disinfect different materials, including minimum surface contact time
  • other items to remember, including checking expiry dates of cleaning and disinfectant products and following the manufacturer’s instructions

Public Services Health and Safety Association’s Child Care Centre Employer Guideline provides information on cleaning and Health Canada's hard-surface disinfectants and hand sanitizers (COVID‑19) web page provides information on approved products.

Cleaning products

Products that provide both cleaning and disinfection action are preferable due to ease of use (for example, hydrogen peroxide products). Only use cleaning and disinfectant products that have a Drug Identification Number (DIN). Check the expiry date of the agents prior to use. These should be used according to the manufacturer's instructions.

Cleaning program 

Child care centres and home child care premises should be cleaned frequently. Focus should be on regular hand hygiene to reduce the risk of infection related to high touch surfaces. Cleaning plus disinfection twice daily is suggested at a minimum, however, more frequent cleaning and disinfection may be necessary, depending on the frequency of use and extent of soilage.

  • Frequently touched surfaces include but are not limited to washrooms (for example toilet fixtures, faucets), eating areas (for example, tables, sinks, countertops), doorknobs, light switches, handles, desks, phones, keyboards, touch screens, push buttons, handrails, computers, photocopiers, sports equipment, water fountain knobs.

It is recommended that licensees keep a cleaning and disinfecting log to track and demonstrate cleaning schedules.

Shared spaces and objects

The risk associated with transmission with shared objects is low. Instead of regular cleaning of shared objects, the focus should be on regular hand hygiene and respiratory etiquette to reduce the risk of infection related to shared equipment. This is especially the case for young children where shared equipment is important for learning (for example, toys for imaginative play, manipulatives for math).

Where an individual is suspected of having COVID‑19 in the child care setting:

  • Establish a protocol to determine contaminated areas and carry out cleaning and disinfection, including timing, when to return to use, methods of cleaning, PPE to be used while cleaning, and waste disposal.
  • Identify areas that may require cleaning plus disinfection (items used by the individual and all surfaces within two metres of the ill person) versus cleaning alone (such as a hallway or room where the individual has passed through).

Hand hygiene and respiratory etiquette

Appropriate hand hygiene and respiratory etiquette are among the most important protective strategies. Child care staff, home child care providers, home child care visitors and students on educational placement should be trained and able to assist children on appropriate hand hygiene and respiratory etiquette, including the use of alcohol-based hand rub (ABHR), and reinforcing its use.

Hand hygiene should be conducted by anyone entering the child care setting and incorporated into the daily schedule at regular intervals during the day, above and beyond what is usually recommended (for example, before eating food, after using the washroom).

Child care staff, home child care providers, home child care visitors, students on educational placement and children should be provided with targeted, age-appropriate education in proper hand hygiene and respiratory etiquette. Local public health units can provide additional guidance. Age-appropriate posters or signage should be placed around the child care setting.

  • Soap and water are preferred as the most effective method and least likely to cause harm if accidentally ingested.
  • ABHR  with a minimum 60% alcohol concentration must be available (60-90% recommended, including ideally at the entry point to each child care room) and/or plain liquid soap in dispensers, sinks and paper towels in dispensers.
  • ABHR can be used by children. It is most effective when hands are not visibly soiled.
  • When hands are visibly soiled (for example, dirt, blood, body fluids (urine/feces)), hands are to be washed with soap and water.
  • Safe placement of the ABHR to avoid consumption is important, especially for young children.
  • Support or modifications should be provided to allow children with special needs to regularly perform hand hygiene as independently as possible.
  • Tissues and lined, no-touch waste baskets (for example, foot pedal-operated, hand sensor, open basket) are to be provided, where possible.

Refer to Public Health Ontario's how to wash your hands (PDF) fact sheet and respiratory etiquette infographic.

Refer to Health Canada's hard-surface disinfectants and hand sanitizers (COVID‑19): list of hand sanitizers authorized by Health Canada, including which sanitizers may be appropriate for different groups of staff and students.

Use of masks and other personal protective equipment (PPE)

Licensees must include information on the use of PPE in their health and safety protocols that is consistent with the information in this section as well as any direction provided by their local public health unit.

At the advice of the local public health unit, child cares centres may choose to implement additional masking measures based on local circumstances.

Reasonable exceptions to the requirement to wear masks are expected to be put in place by licensees. Exceptions to wearing masks indoors could include situations where a child cannot tolerate wearing a mask, reasonable exemptions for medical conditions, etc.

Licensees should ensure their masking exceptions policies support children and staff to wear masks to the greatest extent possible.

Licensees may discuss with parents/guardians, in consultation with the child’s health care professional, whether other types of face coverings might work for the child.

Licensees should consider ways to support nutrition breaks in a safe manner (for example, a space where staff/providers can maintain at least two metres distance to remove masks and eat).

Licensees should document their requirements and exemptions related to masks (such as, within their COVID‑19 policy).

Expectations for adults in a child care setting

All child care staff, home child care providers, home child care visitors and students on educational placement are required to wear medical masks (for example, surgical/ procedural) or N95 masks (can be non-fit-tested) while inside a child care setting, including in hallways and staff rooms (unless eating – but time with masks off should be limited and physical distance should be maintained).

Eye protection (face shield or goggles) is required both indoors and outdoors, as per occupational health and safety requirements for individuals working in close contact with children who are not wearing masks. Eye protection is not required for individuals working with children who wear masks.

All child care staff, home child care providers, home child care visitors and students on educational placement are required to wear medical masks when providing transportation for children. Eye protection for drivers should not interfere with the safe operation of vehicles and is intended to protect drivers during close contact with children, such as during boarding and exiting.

Masking is not required outdoors when two metres of distance is maintained from others. Physical distancing is strongly encouraged between groups.

Expectations for children

All children in grades 1 and above are required to wear a well-fitted mask (can be non-medical or cloth) while inside a child care setting, including in hallways.

Children can remove masks indoors to consume food or drink only, with a minimum distance of two metres maintained between cohorts.

Children younger than grade 1 are encouraged to wear a non-medical or cloth mask while inside a child care setting, including in hallways.

Masks are not recommended for children under the age of two.

  • Parents/guardians are responsible for providing their child(ren) with a non-medical mask(s) or face covering each day and should be reminded that if children are wearing masks, they will require a way to store their mask when not in use.

Masking is not required outdoors. Children should stay within their cohort as much as possible during breaks outdoors. Physical distancing is strongly encouraged between groups.

Proper use of masks and PPE

Refer to Public Health Ontario resources and the Public Health Agency of Canada (PHAC) website for how to properly wear and take off masks and eye protection. You may also wish to view a helpful video on how to properly put on and take off masks and eye protection.

Keep in mind that it may be difficult to put on a mask and eye protection properly (without contamination) after having removed them, given the frequent and spontaneous need for close interactions with young children in a child care setting.

Masks should be replaced when they become damp or visibly soiled.

The use of medical masks and eye protection is for the safety of child care staff/providers and the children in their care. This is especially important when working with individuals who may not be wearing face coverings (for example, young children under the age of two).

Sourcing PPE

Child care licensees and home child care providers should secure and sustain an amount of PPE (including but not limited to face shields or goggles, medical masks, N95 masks (non-fit-tested), gloves, etc.) and cleaning supplies that can support their current and ongoing operations.

To support healthy and safe operation of child care programs, a supply of medical masks, N95 masks (non-fit-tested) and eye protection (face shields) is being procured and delivered through the Ministry of Government and Consumer Services to licensed child care centres and home child care agencies on a monthly basis.

  • The N95 masks meet NIOSH standards but have not been, and are not required to be, fit-tested. Staff/providers will have the option to wear either medical/surgical masks or an N95 mask (non-fit-tested) provided by the government.
  • A back-up supply of high quality three-ply cloth masks for children in care will also be made available to licensees upon request.

The Ontario Together Portal has a Workplace PPE Supplier Directory that lists Ontario businesses that provide PPE and other supplies.

Screening for symptoms

All individuals entering the child care premises must self-screen every day before attending the program using the provincial screening tool or a screening tool designated by the local public health unit. The province will continue to provide a COVID‑19 screening tool for use by schools and child care and may update this frequently throughout the year. All individuals must follow the monitoring and isolation advice outlined in the screening tool. Local public health units may designate a commensurate or more restrictive screening tool for local use.

The ministry may direct licensees and providers to perform daily on-site confirmation of self-screening, such as during a period of potential higher transmission (for example, after a holiday period). Licensees are expected to have a process in place to validate the daily self-screening of these individuals prior to or upon their arrival at the child care premises if directed to do so. Confirmation or proof of self-screening should be in a form deemed appropriate and accessible by the licensee (for example, proof of completed paper copy of screener, mobile application indicating a “pass”).

Screening for child care centres

All child care centre staff, students on educational placement, and visitors must self-screen.

Any individuals that do not pass the screening procedures will be asked to remain home and self-isolate. See the provincial COVID‑19 screening tool for symptom screening, monitoring and isolation procedures.

At the advice of the local public health unit, licensees may choose to implement additional screening measures based on local circumstances.

Screening for home child care

Home child care providers and any others staying at the premises must conduct a daily self-screen and screen all other members of the household before providing child care.

If the provider or any other member of the household does not pass the screening, the individual should remain at home and self-isolate, and the provider should notify the home child care agency and must not provide child care.

All household members of the symptomatic individual, regardless of vaccination status, must isolate while the symptomatic individual is isolating.

See the provincial COVID‑19 screening tool for symptom screening, monitoring and isolation procedures.

At the advice of the local public health unit, home child care agencies may choose to implement additional screening measures based on local circumstances.

Screening for children

Parents and guardians are to screen their children for symptoms of illness every day before attending child care. The provincial COVID‑19 screening tool is available to support parents and guardians to meet this requirement.

Parents or guardians of any child that has not completed the screening for symptoms prior to arriving at the child care setting will be required to complete screening prior to entry.

Any child that does not pass the on-site screening procedures will be asked to return home and self-isolate. See the provincial COVID‑19 screening tool for symptom screening, monitoring and isolation procedures.

At the advice of the local public health unit, licensees may choose to implement additional screening measures based on local circumstances.

General screening requirements

It is the responsibility of the licensee to ensure that all screening procedures (including on-site screening) are completed and to ensure that no individual enters the premises unless they have completed the screening and the result of that screening has indicated that they are allowed to proceed.

Licensees should post signs at entrances to the child care setting to remind staff, parents/caregivers and visitors of screening requirements.

Licensees should make self-assessment tools available to staff to ensure awareness of possible symptoms of COVID‑19.

Licensees may wish to consult the province’s COVID‑19 website for information and resources on COVID‑19 symptoms, protections and seeking health care.

For screening an individual at the child care setting and escorting children to the program, licensees should take appropriate precautions including, maintaining a distance of at least two metres from those being screened, being separated by a physical barrier (such as a plexiglass barrier), and providing alcohol-based hand rub containing 60% to 90% alcohol content at all screening stations.

Note: Where licensees have chosen to screen individuals using rapid antigen tests, screening is subject to the consent of the individual. Ministry staff are not required to participate but may do so to at the request of the licensee. Ministry staff cannot be denied access to the premises if they do not wish to conduct a rapid antigen test as part of screening.

Transportation

All child care staff, home child care providers, and students on educational placement and other adults are required to wear medical masks or N95 masks (may be non-fit-tested). Eye protection should be used as per occupational health and safety requirements. Eye protection for drivers should not interfere with the safe operation of vehicles and is intended to protect drivers during close contact, such as during boarding and exiting.

The use of non-medical masks or face covering for children grades 1 and above is required on vehicles. Children below grade 1 are strongly encouraged to wear masks on transportation. Licensees should support accommodations for immunocompromised and otherwise medically vulnerable children, and children with special transportation needs.

Children should be assigned seats and a record of the seating plan should be kept. Children who live in the same household should be seated together where possible.

Training, where appropriate as per occupational health and safety requirements under the Occupational Health and Safety Act, should be provided to ensure that health and safety measures to protect against COVID‑19 are understood, followed and enforced in all transportation settings.

Health and safety measures should be clearly communicated to parents and guardians to ensure their comfort with the adapted transportation system and receive their support in having children understand and follow guidelines.

Vehicles should follow an enhanced cleaning protocol of disinfecting high-touch surfaces (for example, handrails, seatbacks) at least twice daily.

Transportation service providers should also consider the Health and Safety Guidance During COVID‑19 for Student Transportation Employers released by the Public Services Health and Safety Association.

Attendance records

In addition to attendance records for all children receiving child care, all child care licensees are responsible for maintaining daily records of anyone entering the child care facility/home.

These records must include all individuals who enter the premises (such as parents and guardians dropping off children, cleaners, people doing maintenance work, people providing supports for children with special needs, those delivering food).

  • Records are to be kept on the premises (centre or home) and along with name and contact information must include an approximate time of arrival and time of departure and screening completion for each individual.
  • Records must be kept up-to-date and available to public health within 24 hours if requested.

Monitoring and responding to reports of COVID-19 symptoms in a child care setting

See the provincial COVID‑19 screening tool and interim guidance for schools and child care Omicron surge for symptom screening, monitoring and isolation procedures. All individuals must follow the monitoring and isolation advice outlined in the screening tool.

Ill individuals should not attend child care. Individuals who have tested positive on a COVID‑19 test (PCR, rapid molecular, or rapid antigen) should self-isolate immediately and follow isolation guidance as outlined in provincial COVID‑19 screening tool, the COVID‑19 integrated testing & case, contact and outbreak management interim guidance: Omicron surge document, and the Interim guidance for schools and child care: Omicron surge, and any additional guidance from their local public health unit for isolation and returning to a child care setting. Note that individuals do not need to provide a medical note or proof of negative result to return to the program.

If an individual becomes ill while in the child care setting:

  • The ill individual must be immediately separated from others, in a separate room where possible (an isolation room). Parents/guardians must be contacted for pick-up of symptomatic children.
  • Symptomatic children who are separated from others must be supervised.
  • Anyone providing care to the ill individual should maintain as much physical distance as possible. If physical distancing is not possible (for example, if a young child needs comfort) staff/providers should consider additional PPE like gloves, gown).
  • The person caring for the individual must wear a medical mask or N95 mask (may be non-fit-tested) and eye protection and be trained on proper use of PPE, including donning and doffing.
    • If tolerated, the ill individual should also wear a medical mask.
  • Hand hygiene and respiratory etiquette should be practiced while the ill individual is waiting to be picked up.
  • Cleaning of the area the separated individual was in and other areas of the child care setting where the ill individual was should be conducted as soon as reasonably possible after the ill individual leaves (see the cleaning section).
  • For home-based programs: if a person who resides in the home develops COVID‑19 symptoms, they should be isolated away from the children and any spaces accessed by children participating in child care, and infection prevention and control measures should be adhered to (such as daily cleaning, frequent cleaning/disinfecting of high touch surfaces, frequent hand washing).
  • The ill individual and their parent or guardian should be advised to use the online self-assessment tool and follow instructions which may include seeking medical advice and/or going for testing for COVID‑19.
  • Regular child care operation can continue unless directed otherwise by the local public health unit.
  • An ill individual who has a known alternative diagnosis provided by a health care professional may return to child care if they do not have a fever and their symptoms have been improving for at least 24 hours, or 48 hours if vomiting or experiencing diarrhea.

All child care and early years sector partners, together with Ministry of Health and local Public Health units, will work closely to monitor and respond to reports of COVID‑19 symptoms.

Reporting and serious occurrence reporting

Where a licensee chooses to close the entire child care centre or home premises, or the local public health unit determines that a full or partial closure is required, a serious occurrence report must be submitted to the ministry under the "Unplanned Disruption of Service" category in the Child Care Licensing System. Please also note there are requirements of employers to let workers know if they may have been exposed in the workplace. Please see the guide on developing a COVID‑19 workplace safety plan for more information.

To support ongoing monitoring and transparency related to COVID‑19 impacts on child care, the ministry is encouraging licensees to monitor absenteeism rates in their programs. Given the widespread transmission of the Omicron variant and changes to the provincial testing approach, child care operators will no longer be routinely notifying families of positive cases or if an individual is absent due to symptoms associated with COVID‑19.

If absenteeism rises to a defined level in a child care program (approximately 30% above baseline), licensees are expected to send a template notification to families and staff/providers in the affected child care setting, signed by the local medical officer of health, with information on public health measures for families and staff/providers to follow (for example, monitoring of COVID‑19 symptoms). Licensees are encouraged to reach out to their local PHU in this scenario to get access to the required template.

Outbreak management

In response to the evolving situation related to the COVID‑19 Omicron (B.1.1.529) variant of concern, the Ministry of Health has provided interim public health guidance on case, contact, and outbreak management for schools and child care settings.

The COVID-19: interim guidance for schools and child care: Omicron surge guidance, which can be found on the Ministry of Health’s website, provides the direction for local public health units on the management of COVID‑19 cases, contacts and outbreaks in child care settings.

Public health directed cohort based dismissals are no longer likely to occur in child care settings. Unless specific direction is provided by the local public health unit, closures are at the discretion of the licensee. Licensees are encouraged to communicate clearly with families and staff so that they are aware of any closures and how they may be impacted.